scholarly journals The temporal relationship between early postoperative delirium and postoperative cognitive dysfunction in older patients: a prospective cohort study

2014 ◽  
Vol 61 (12) ◽  
pp. 1084-1092 ◽  
Author(s):  
Emily Youngblom ◽  
Glen DePalma ◽  
Laura Sands ◽  
Jacqueline Leung
Keyword(s):  
Cohort Study ◽  
Cognitive Dysfunction ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Temporal Relationship ◽  
Postoperative Cognitive Dysfunction

scholarly journals Association of postoperative covert stroke and cognitive dysfunction among elderly patients undergoing non-cardiac surgery: protocol for a prospective cohort study (PRECISION study)

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034657 ◽  
Author(s):  
Qianyu Cui ◽  
Dexiang Wang ◽  
Min Zeng ◽  
Jia Dong ◽  
Hailong Jin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cohort Study ◽  
Elderly Patients ◽  
Cognitive Dysfunction ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Brain Mri ◽  
Postoperative Cognitive Dysfunction ◽  
Ageing Population ◽  
Increased Risk

IntroductionThe incidence of covert stroke and cognitive dysfunction has gradually increased due to an ageing population. Recently, a prospective cohort study reported perioperative covert stroke was associated with an increased risk of postoperative cognitive dysfunction (POCD) 1 year after non-cardiac surgery. However, the mechanism remains unclear.Methods and analysisThis is a prospective observational trial aiming to investigate the cumulative incidence of perioperative covert stroke and test the hypothesis that perioperative covert stroke associates with POCD in elderly patients undergoing non-cardiac and non-neurological surgery. Data on risk factors, brain MRI, cognitive function evaluation and serum immune-inflammatory cytokines will be collected and analysed.Ethics and disseminationEthical approval has been granted by the Medical Ethics Committee of Beijing Tiantan Hospital, Capital Medical University (reference number: KY2017-027-02). The results of this study will be disseminated through presentations at scientific conferences and publication in scientific journals.Trial registration numberNCT03081429.

Preventable hospitalizations among older patients with cognitive impairments and dementia

2018 ◽  
Vol 31 (3) ◽  
pp. 383-391 ◽  
Author(s):  
Dominik Wolf ◽  
Carolin Rhein ◽  
Katharina Geschke ◽  
Andreas Fellgiebel
Keyword(s):  
Cohort Study ◽  
Hospital Stay ◽  
Ambulatory Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Hospital Admissions ◽  
Cognitive Impairments ◽  
Length Of Hospital Stay ◽  
Complication Rates

ABSTRACTObjectives:Dementia and cognitive impairment are associated with higher rates of complications and mortality during hospitalization in older patients. Moreover, length of hospital stay and costs are increased. In this prospective cohort study, we investigated the frequency of hospitalizations caused by ambulatory care-sensitive conditions (ACSCs), for which proactive ambulatory care might prevent the need for a hospital stay, in older patients with and without cognitive impairments.Design:Prospective cohort study.Setting:Eight hospitals in Germany.Participants:A total of 1,320 patients aged 70 years and older.Measurements:The Mini-Cog test has been used to assess cognition and to categorize patients in the groups no/moderate cognitive impairments (probably no dementia) and severe cognitive impairments (probable dementia). Moreover, lengths of hospital stay and complication rates have been assessed, using a binary questionnaire (if occurred during hospital stay or not; behavioral symptoms were adapted from the Cohen-Mansfield Agitation Inventory). Data have been acquired by the nursing staff who received a special multi-day training.Results:Patients with severe cognitive impairments showed higher complication rates (including incontinence, disorientation, irritability/aggression, restlessness/anxiety, necessity of Tranquilizers and psychiatric consults, application of measures limiting freedom, and falls) and longer hospital stays (+1.4 days) than patients with no/moderate cognitive impairments. Both groups showed comparably high ACSC-caused admission rates of around 23%.Conclusions:The study indicates that about one-fourth of hospital admissions of cognitively normal and impaired older adults are caused by ACSCs, which are mostly treatable on an ambulatory basis. This implies that an improved ambulatory care might reduce the frequency of hospitalizations, which is of particular importance in cognitively impaired elderly due to increased complication rates.

scholarly journals Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021708 ◽  
Author(s):  
Leslie SP Eide ◽  
Anette H Ranhoff ◽  
Sandra Lauck ◽  
Bengt Fridlund ◽  
Rune Haaverstad ◽  
...  
Keyword(s):  
Cohort Study ◽  
Aortic Valve ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Postoperative Delirium ◽  
Primary Outcome ◽  
University Hospital ◽  
Transcatheter Aortic Valve ◽  
The Difference ◽  
Valve Implantation

ObjectivesTo determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI).DesignProspective cohort study.SettingTertiary university hospital covering the western region of Norway.ParticipantsOctogenarian patients undergoing elective SAVR or TAVI and willing to participate in the study were eligible. Patients unable to speak Norwegian were excluded. Between 2011 and 2013, 143 consecutive patients were included, and data from 136 of them are presented.Primary outcomeDelirium.ResultsLogistic regression analysis shows that lower cognitive function was positively associated with delirium (OR 0.86, CI 0.74 to 0.99, p=0.047). Besides, the interaction term in the model shows that IUC use and delirium differed between SAVR and TAVI patients (p=0.04). The difference corresponded to a weaker association between hours of IUC use and delirium for SAVR (OR 1.01, CI: 0.99 to 1.03, p=0.54) compared with that for TAVI (OR 1.04, CI: 1.01 to 1.08, p=0.004).ConclusionsThe association between IUC use and delirium is stronger for octogenarian patients treated with TAVI than for patients who received SAVR. Our results revealed a previously unknown association between the number of hours an IUC is used and postoperative delirium in octogenarian patients treated with TAVI.

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